Active NPI
Scott James Minnich, D.D.S.
- Dentist
- Saint Louis, MI
National Provider Identifier
1487930384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901015172
- Practice address
- 8201 N Croswell Rd
Saint Louis, MI 48880-9210 - Phone
- (989) 681-4362
- NPI assigned
- Oct 25, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901015172 | MI | Primary |
Addresses
Primary practice location
8201 N Croswell Rd
Saint Louis, MI 48880-9210
Mailing address
8201 N Croswell Rd
Saint Louis, MI 48880-9210
Phone (989) 681-4362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901015172 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319500800000",
"number": "1487930384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8201 N CROSWELL RD",
"city": "SAINT LOUIS",
"state": "MI",
"postal_code": "488809210",
"telephone_number": "989-681-4362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8201 N CROSWELL RD",
"city": "SAINT LOUIS",
"state": "MI",
"postal_code": "488809210",
"telephone_number": "989-681-4362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINNICH",
"first_name": "SCOTT",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-25",
"last_updated": "2011-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901015172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.